Sural sensory action potential identifies diabetic peripheral neuropathy response to therapy

Aaron I. Vinik, Vera Bril, William J. Litchy, Karen L. Price, Edward J. Bastyr

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Identifying patients with diabetic peripheral neuropathy (DPN) amenable to therapy is a challenge. To determine whether the amplitude of the sural sensory nerve action potential (sural SNAP) reflects the severity of DPN, an analysis was performed on 205 patients with DPN, identified by an abnormal vibration detection threshold (VDT), who were enrolled in a multinational clinical trial investigating ruboxistaurin (RBX) mesylate. Nerve conduction velocity and response amplitude and latency were measured and compared. VDT was significantly lower in those with preserved sural SNAPs (n = 128) than in those in whom they were absent (n = 77; 21.5 vs. 22.7 JND units, P = 0.002). Thus, preserved sural SNAP denoted less severe DPN. Logistic regression analyses evaluating baseline characteristics, HbA1c, and baseline symptom scores identified only DPN duration as a factor that might contribute to the presence of sural SNAP (P = 0.004; OR = 0.896). For patients with abnormal VDT, preserved sural SNAP identifies a patient population with less severe DPN who may respond to therapeutic intervention in clinical trials.

Original languageEnglish (US)
Pages (from-to)619-625
Number of pages7
JournalMuscle and Nerve
Issue number5
StatePublished - Nov 2005


  • DPN, diabetic peripheral neuropathy
  • PKC β, protein kinase C β
  • Sural SNAP, sural sensory nerve action potential
  • VDT, vibration detection threshold
  • VP, vibration perception

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)


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